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The floating pulse can be understood as the sensation of pressing on wood floating on water, or like a small boat floating on the surface of the water. This means that the pulse wave is located relatively superficially under the skin, so it can be felt with slight pressure from the fingers, and the force of the pulse is slightly weakened. This pulse pattern is commonly seen in exterior syndromes, most notably in cases of wind-cold or wind-heat colds.
The presence of a floating pulse indicates the body’s own effort to expel pathogens. When external pathogens invade the superficial layers, the defensive Yang (wei yang) fights against the pathogens externally, and the body’s Qi and blood move towards the superficial layers, causing the pulse to rise and appear floating. When the righteous Qi is not deficient and the pathogenic Qi is strong, the pulse appears floating and forceful.
When there is a deficiency of Qi and blood along with an external invasion, or when the righteous Qi is weak and the pathogenic Qi is strong, the pulse will appear floating but weak. In cases of external invasion by wind-cold, the pulse often presents as floating and tight. In cases of wind-heat invasion, due to heat causing vigorous blood flow, the pulse appears floating and rapid.
For a floating and tight pulse, accompanied by chills and fever, with or without sweating, headache, and aching limbs, one can use Ma Huang Tang (Ephedra Decoction) or Gui Zhi Tang (Cinnamon Twig Decoction). If the floating pulse is accompanied by external dampness and internal heat, Jiu Wei Qiang Huo Tang (Nine Herb Decoction) can be used to induce sweating, dispel dampness, and clear internal heat.
If there is an external invasion of cold and dampness, in addition to a floating pulse, with chills, fever, no sweating, abdominal pain, vomiting, diarrhea, and a heavy head and body, Xiang Ru San (Elsholtzia Powder) can be used to dispel summer heat and resolve the exterior.
The herb Xiang Ru (Elsholtzia) is known as the essential herb for resolving exterior conditions in summer; it is particularly effective for summer external cold-damp conditions. When there is an external invasion of wind-cold, with phlegm and fluids stagnating internally leading to chills, fever, no sweating, cough, and wheezing, or when there is excessive phlegm making it difficult to lie flat, or when there is swelling of the body, face, and limbs, Xiao Qing Long Tang (Minor Blue Dragon Decoction) can be used for treatment. The ingredients Ban Xia (Pinellia) and Gan Jiang (Dried Ginger) are warm in nature and assist Ma Huang in resolving the exterior.
For a floating and rapid pulse, accompanied by chills, sweating, or difficulty sweating, Yin Qiao San (Honeysuckle and Forsythia Powder) or Sang Ju Yin (Mulberry Leaf and Chrysanthemum Decoction) can be used. When there is a wind-heat exterior syndrome with cough and shortness of breath, and possibly a stuffy nose, thirst, and a floating, slippery, and rapid pulse, Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) can be taken orally.
In this formula, Shi Gao (Gypsum) is particularly effective in clearing heat from the lungs and stomach, and can also generate fluids. When chills gradually lessen, and body heat increases, with headache, dry nose, irritability, insomnia, and pain around the eyes, Chai Ge Jie Ji Tang (Bupleurum and Kudzu Decoction) can be used for treatment.
When the body presents a floating pulse, based on specific manifestations and whether there has been exposure to cold or consumption of excessively cold foods, one can assess the body’s condition and provide timely treatment to promote recovery from illness.
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